Latyshev Yevgeniy A, Avendano John P, Patankar Sohil
Division of Cardiology, Jersey Shore University Medical Center, Neptune City, NJ 07753, USA.
HMH Interventional Cardiology, East Brunswick, NJ 08816, USA.
J Med Cases. 2023 Feb;14(2):76-79. doi: 10.14740/jmc4037. Epub 2023 Feb 25.
Coronary artery aneurysms (CAAs) are found in a small percentage of coronary angiograms, with left main coronary artery (LMCA) aneurysms being the least common. We present a 63-year-old male patient with a history of chest pain and an abnormal nuclear stress test. Cardiac catheterization showed a large LMCA aneurysm with unusual quadfurcation left main (LM) anatomy, but otherwise showed no evidence of obstructive coronary artery disease. The patient remained clinically stable, and a repeat cardiac catheterization 2 years later showed unchanged coronary anatomy. Further medical management with close observation was elected. This case illustrates that in select cases, large LMCA aneurysms can be successfully managed medically without surgical or percutaneous interventions. To our knowledge, this is the first report of LMCA aneurysm with quadfurcation anatomy. In addition to the case description, a review of the literature is provided.
冠状动脉瘤（CAAs）在冠状动脉造影中所占比例较小，其中左主干冠状动脉（LMCA）瘤最为少见。我们报告一例63岁男性患者，有胸痛病史且核素负荷试验异常。心导管检查显示一个巨大的LMCA瘤，伴有不寻常的左主干四分支解剖结构，但未发现阻塞性冠状动脉疾病的证据。患者临床情况保持稳定，2年后再次心导管检查显示冠状动脉解剖结构未变。遂选择密切观察的进一步药物治疗方案。该病例表明，在某些特定情况下，大型LMCA瘤无需手术或经皮介入即可通过药物成功治疗。据我们所知，这是首例关于具有四分支解剖结构的LMCA瘤的报告。除病例描述外，还提供了文献综述。
